Employment Application


Step 1

Personal Information

Step 2

Employment History

Provide the following information for your past employers.

Step 3

Education & Skills

Step 4

Professional References

Persons not related to you who are familiar with your experience, training and character. Examples: employers, supervisors, teacher or co-workers.

Step 5


Attach your resume in Word (*.doc, *.docx) or PDF (*.pdf) format.

Job Applicant's Agreement & Certification

I certify that I have answered all inquires on this application truthfully to the best of my knowledge and belief. I understand that my failure to disclose, or my falsification of, any information requested of me during the pre-employment process may disqualify me from consideration for employment or lead to the termination of my employment.


I understand that, as part of its pre-employment process, Amherst Madison, Inc. requires that all applicants to whom an offer of employment is extended must undergo a physical examination and physical evaluation of overall fitness to determine if I can perform the essential functions of the job, with or without reasonable accommodation. I also understand that Amherst Madison, Inc. requires post-offer urine drug testing for towboat applicants. I understand and agree that any offer of employment Amherst Madison, Inc. may extend is contingent upon obtaining a negative result on the drug testing. I further understand that any applicant who tests positive for drugs or who fails or refuses to undergo the drug testing will be ineligible for employment at Amherst Madison, Inc., in accordance with Company policy and applicable Coast Guard regulations, 46 CFR Part 16.


I understand that all employment relationships with the Company are "at will," which means that I may resign at any time and the Company may discharge me at any time with or without cause. I further understand that no manager or representative of the Company, other than the President, has the authority to enter into any promises or commitments contrary to the above, including making any agreement for employment for any specified period of time, and that any such agreement must be in writing and signed by the President and the affected individual.



Confidential AMHERST MADISON, INC. Voluntary Self-Identification

Amherst Madison, Inc. is an equal employment opportunity employer. Individuals are considered for positions at Amherst Madison, Inc. without regard to race, color, creed, religion, sex, national origin, age, marital status, veteran status, disability and any other legally protected status. Amherst Madison, Inc. is also subject to certain governmental record keeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, Amherst Madison, Inc. invites employees and job seekers to voluntarily self-identify their gender, race and ethnicity, below.


Completion of this form is voluntary. If you choose not to provide this information, it will not affect any opportunities for employment or benefits. If you do complete this form, any information you provide will be kept confidential, will not be used against you in any way, and will be used only in compliance with applicable laws, executive orders, and regulations.